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Type 1 diabetes patients increase CXCR4+ and CXCR7+ haematopoietic and endothelial progenitor cells with exercise, but the response is attenuated

Taylor, Guy S.; Shaw, Andy; Smith, Kieran; Capper, Tess E.; Scragg, Jadine H.; Cronin, Michael; Bashir, Ayat; Flatt, Anneliese; Campbell, Matthew D.; Stevenson, Emma J.; Shaw, James A.; Ross, Mark; West, Daniel J.


Guy S. Taylor

Andy Shaw

Kieran Smith

Tess E. Capper

Jadine H. Scragg

Michael Cronin

Ayat Bashir

Anneliese Flatt

Matthew D. Campbell

Emma J. Stevenson

James A. Shaw

Mark Ross

Daniel J. West


Background: Exercise mobilizes angiogenic cells, which stimulate vascular repair. However, limited research suggests exercise-induced increase of endothelial progenitor cell (EPCs) is completely lacking in type 1 diabetes (T1D). Clarification, along with investigating how T1D influences exercise-induced increases of other angiogenic cells (hematopoietic progenitor cells; HPCs) and cell surface expression of chemokine receptor 4 (CXCR4) and 7 (CXCR7), is needed.

Methods: Thirty T1D patients and 30 matched non-diabetes controls completed 45 minutes of incline walking. Circulating HPCs (CD34+ , CD34+ CD45dim) and EPCs (CD34+ VEGFR2+ , CD34+CD45dimVEGFR2+ ), and subsequent expression of CXCR4 and CXCR7, were enumerated by flow cytometry at rest and post-exercise.

Results: Counts of HPCs, EPCs and expression of CXCR4 and CXCR7 were significantly lower at rest in the T1D group. In both groups, exercise increased circulating angiogenic cells. However, increases was largely attenuated in the T1D group, up to 55% lower, with CD34+ (331±437 Δcells/mL vs 734±876 Δcells/mL p=0.048), CD34+VEGFR2+ (171±342 Δcells/mL vs 303±267 Δcells/mL, p=0.006) and CD34+ VEGFR2+CXCR4+ (126±242 Δcells/mL vs 218±217 Δcells/mL, p=0.040) significantly lower.

Conclusion: Exercise-induced increases of angiogenic cells is possible in T1D patients, albeit attenuated compared to controls. Decreased mobilization likely results in reduced migration to, and repair of, vascular damage, potentially limiting the cardiovascular benefits of exercise. Trial registration: ISRCTN63739203

Journal Article Type Article
Acceptance Date Jun 25, 2021
Online Publication Date Jul 15, 2021
Publication Date Jul 15, 2021
Deposit Date Jul 1, 2021
Publicly Available Date Jul 1, 2021
Electronic ISSN 2045-2322
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 11
Article Number 14502
Keywords Type 1 diabetes, exercise, angiogenic cells, haematopoietic progenitor cells, endothelial progenitor cells, exercise-induced mobilisation, CXCR4, CXCR7
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